Abstract:
Massive pulmonary thromboembolism (PE) is a cardiorespiratory emergency and can be fatal if left untreated. The recommended treatment for PE in the presence of right ventricular dysfunction and hemodynamic instability is thrombolysis. However, the latter is a double-edged sword as life-threatening bleeding manifestations can occur post-thrombolysis. Timely identification and management of these complications can prevent a catastrophic outcome. We report a case of mediastinal hematoma with new onset hemodynamic compromise following thrombolysis for acute massive pulmonary embolism. Clinico-radiological features and Point of Care Ultrasound (POCUS) findings helped in the identification of the bleeding site in our case. Despite early diagnosis and timely intervention, the patient succumbed to secondary complications.
摘要:
大量肺血栓栓塞症(PE)是一种心肺急症,如果不及时治疗可能致命。在存在右心室功能障碍和血流动力学不稳定的情况下,推荐的PE治疗方法是溶栓。然而,后者是一把双刃剑,因为溶栓后可出现危及生命的出血表现.及时识别和管理这些并发症可以防止灾难性后果。我们报告了一例纵隔血肿,急性大面积肺栓塞溶栓后出现新的血流动力学受损。在我们的病例中,临床放射学特征和点护理超声(POCUS)的发现有助于确定出血部位。尽管早期诊断和及时干预,病人死于继发性并发症。